On the topic of “long-XXXX”; I’ve had pneumonia several times in past decade. Each time I “largely” recovered within 2 weeks; each time I ultimately fully recovered, but each time I still felt some very mild effects 6-8 weeks after onset. Most studies I’ve seen count it as “long covid” if you are still experiencing any level of symptoms (still a little tired, still a little bit out of breath if you go up stairs, etc) 6 weeks after onset. So each of my pneumonias would have counted as a comparable “long-pneumonia”. I know people who have experienced similar from flu and all sorts of viruses. There do seem to be people who have utterly devastating versions of long-covid, resulting in not being able to get out of bed or go to work, etc. Fortunately, those seem to have been happening far less frequently in 2022 than they did with the initial versions of covid. But either way, those appear to be extremely rare, and it seems that most of the more recent long covid cases don’t strike me as significantly different from my long pneumonias or other long XXXes.
The problem is that “long COVID” is not always consistently defined, and many definitions do not distinguish between a minor effect that lasts for a few months and a major effect that requires ongoing medical care, significantly affects quality of life, and appears to be permanent. The latter is obviously much more concerning than the former.
It does appear that, for any given level of severity and duration of “long COVID”, it was much more common in the pre-vaccine days than “long [other infection]” was. Of the approximately six people I know who got COVID-19 in the pre-vaccine days, one continues to require ongoing medical care, and one had apparent myocarditis for several months. But I have not heard of anything that serious in breakthrough infections of the vaccinated (although some people (particularly primary only, no booster) had very miserable acute phases and required weeks of recovery of lung capacity, particularly during Delta).
Recovery over several weeks from pneumonia is common above a certain age.
I am concerned mainly about neurological effects from COVID for my kid with previous TBI. I don’t have the same fears about most viruses but Epstein Barr did some strange things that eventually abated.
A nasal spray COVID-19 vaccine is available… in India.
iNCOVACC is a viral vector* vaccine delivered by a spray into the nose. A theoretical advantage is that it may stimulate immunity more in the upper respiratory tract, which is the first point of entry for the actual virus. An additional advantage is that it is easier to administer, without the risks of needle errors or the need for as much health care worker training. However, there is no indication that it is aimed at current variants, as opposed to the ancestral virus.
*The J&J and AstraZeneca vaccines are also viral vector vaccines, but they are delivered by injection.
HUH…WHY? Sure seems like these tests can cause no harm and the potential for good outweighs the possible incorrect results…‘“It’s taken a very long time in the past to get new self-tests authorized, like HIV tests or even pregnancy tests," he said. “They’ve taken years and years and years and years. We have a pretty conservative regulatory approach.”’
Other concerns held by the FDA is that people won’t swab correctly - the sample needs to be taken higher up in the nostril. Again, so what? I’d guess a large portion of people would do this correctly.
And the cost is very reasonable in Europe ‘Brus is the founder of Measie, a diagnostics vendor that sells the test online. The test costs 6.5 euros ($6.92), and the company has sold around 10,000 of them thus far, Brus said.’
We recently spent 5 weeks in Europe. Although I brought a number of antigen tests with me - I wound up buying several more rounds. In Germany a box of 5 cost 15 Euro. All five were packaged in on box that was smaller than any box I’ve purchased in the US. Including those with just one test.
In Israel our guide purchased tests for us at a pharmacy. They consisted of a baggie which had the three different components. I didn’t see the actual sale taking place but it sure seems that the pharmacies have a bucket of reagent, a bucket of test strips and a bucket of swabs. Then the sales person just grabs the requisite number of parts from each bucket. Tests cost about 3 euros a piece.
What is wrong with the US???
It has been that way since the early days when the FDA and others in the US were reluctant to endorse antigen tests for quick self testing. So surveillance testing (such as for attending class at school) was done with PCR testing every 3-7 days at most – less frequent, results too late to stop exposure of others, and more expensive compared to daily antigen testing. Precautionary testing (such as just before an event) with PCR meant doing it 2-3 days before to get results, but that meant that someone could become infected and contagious between the test and event.
We’ve had 3 years to learn…and update our procedures.
Most people that test at home now aren’t reporting positive results to a central command :). In fact, it seems that central command either doesn’t exits or couldn’t care less about gathering results anymore.
What the triple home test would provide is a method for those who want to know whether their snotty nose and stuffed head is really ‘just a cold’ or something which might require closer monitoring, or a reason to stay away from granny.
The inability to re-access, adjust, update and modify is clearly not administration dependent. It is systemically ingrained and it is not serving us well.
Seems to be all we have is boost - boost - boost.
I just happened to see on my state’s health department website that they DID start a system to report antigen test results. But they never let anyone know! I also think they should let people know about the extension of expiration dates on covid tests.
My area monitors wastewater for covid, flu and mpox. People have no idea. (There were a few articles about the wastewater monitoring for covid much earlier in the pandemic, but no mention in the media at all that now flu and mpox are also being tracked.) One thing that’s happened is that they (the regional wastewater treatment authority) doesn’t update the charts and maps on the website until AFTER a surge. My friend figured out that is because some of the regional wastewater treatment board members were appointed by the governor, whose stance has been to minimize covid.
Also, curiously, our area’s wastewater isn’t tracked on the CDC’s website. Perhaps our governor is also squelching the release of that information.
However, even if the government went a lot further than it did (with the 24 free rapid tests delivered by the USPS – a lot better than nothing, but not enough for multiperson households who would use them before every event) in making rapid tests widely available, it is likely that many people in the US would not bother with them, since they are mainly something that can protect other people, rather than users.
So what is left is just measures to protect oneself if one does not want to get COVID-19. This means getting the BA.5 booster (except for those medically unable to get vaccinated; those who have hybrid immunity including a BA.5 or more recent infection may not gain much compared to others), wearing well fitting N95 (or similar) masks in any risk situation, and avoiding risk situations generally, although none of these is 100% effective.
Preprint about the XBB.1.5 variant:
A: XBB.1.5 evades antibodies from hybrid immunity with BA.1, BA.5, or BF.7 infection; mRNA vaccination does better than CoronaVac (inactivated virus) vaccination here.
B: Most monoclonal antibodies are ineffective or much less effective against XBB.1.5.
C: XBB.1.5 sticks to human ACE2 better than BQ.1.1 or XBB/XBB.1.
I guess I’ll stick with boost, boost, boost. 
@ucbalumnus, thank you so much for your informative posts!
Deja vu. Government does not learn from its mistakes.
Cites this study:
The USPS website to order the latest round of rapid tests had a link to check expiration of old tests.
Regarding Individuals With Persistent Fatigue, Cognitive, and Respiratory Symptom Clusters After COVID-19 , it looks like the risk of a long COVID symptoms (as defined in the article) is increased with greater severity in the acute phase (i.e. ICU > hospitalized > non-hospitalized). It also looks like women are much more likely to have long COVID than men, and that many (but not all) of those who had long COVID 3 months after no longer had it 12 months after.
They are currently looking for volunteers to participate in the study.
YLE has a new page with some notes on COVID-19 research: COVID-19 Research Round-up - by Katelyn Jetelina
- Moderna vaccine appears to be more effective than Pfizer vaccine against COVID-19 outcomes in VA health records study: Comparative effectiveness of third doses of mRNA-based COVID-19 vaccines in US veterans | Nature Microbiology
- Hybrid immunity including BA.1 or BA.2 infection appeared to give 94% protection against BA.5 infection at 3 months, then falling and leveling off to 63% protection against BA.5 infection at 8 months, compared to those with vaccination but not prior infection: Stability of hybrid versus vaccine immunity against BA.5 infection over 8 months - The Lancet Infectious Diseases
- In prisons, vaccination only, prior infection only, and both vaccination and prior infection reduced the risk of someone with COVID-19 giving it to others by 22%, 23%, and 40% respectively, compared to unvaccinated getting COVID-19 the first time: Infectiousness of SARS-CoV-2 breakthrough infections and reinfections during the Omicron wave | Nature Medicine
- Mask requirements in schools were associated with lower rates of COVID-19: https://www.nejm.org/doi/full/10.1056/NEJMoa2211029
- Novavax vaccine appeared to be less effective than Pfizer, Moderna, or AstraZeneca vaccine in Australia: https://www.medrxiv.org/content/10.1101/2022.12.22.22283869v1.full-text
- “A JAMA study found that the risk of long COVID decreased with vaccination. But after the third shot, protection against long COVID-19 plateaued. More research is needed, as this is surprising.” But no link to study provided.
From the CDC web site: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/bivalent-boosters.html